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NORTH LAKE PHARMACY LLC - Florida Company Profile

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Company Details

Entity Name: NORTH LAKE PHARMACY LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 29 Feb 2016 (9 years ago)
Document Number: L16000041541
FEI/EIN Number 81-1771003
Address: 9091 NORTH MILITARY TRAIL, SUITE 17, NORTH PALM BEACH, FL, 33410, US
Mail Address: 9091 NORTH MILITARY TRAIL, SUITE 17, NORTH PALM BEACH, FL, 33410, US
ZIP code: 33410
City: Palm Beach Gardens
County: Palm Beach
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Soufan Salim President 8552 THOUSAND PINES COURT, WEST PALM BEACH, FL, 33411
SOUFAN SALIM Agent 8552 THOUSAND PINES COURT, WEST PALM BEACH, FL, 33411
BLOUNT ROBERT Manager 9091 N MILITARY TRL, PALM BEACH GARDENS, FL, 33418

National Provider Identifier

NPI Number:
1992468755
Certification Date:
2021-10-19

Authorized Person:

Name:
PAUL O CONNOR
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
3336L0003X - Long Term Care Pharmacy
Is Primary:
Yes

Contacts:

Fax:
5616199902

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2016-05-13 9091 NORTH MILITARY TRAIL, SUITE 17, NORTH PALM BEACH, FL 33410 -
CHANGE OF MAILING ADDRESS 2016-05-13 9091 NORTH MILITARY TRAIL, SUITE 17, NORTH PALM BEACH, FL 33410 -

Documents

Name Date
ANNUAL REPORT 2025-02-05
ANNUAL REPORT 2024-02-01
ANNUAL REPORT 2023-01-25
ANNUAL REPORT 2022-01-22
ANNUAL REPORT 2021-01-19
ANNUAL REPORT 2020-03-18
ANNUAL REPORT 2019-02-13
ANNUAL REPORT 2018-01-23
ANNUAL REPORT 2017-04-27
Florida Limited Liability 2016-02-29

USAspending Awards / Financial Assistance

Date:
2020-05-11
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
26772.00
Total Face Value Of Loan:
26772.00
Date:
2020-05-11
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
26772.00
Total Face Value Of Loan:
26772.00

Paycheck Protection Program

Jobs Reported:
3
Initial Approval Amount:
$26,772
Date Approved:
2020-05-11
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$26,772
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$27,326.78
Servicing Lender:
Fifth Third Bank
Use of Proceeds:
Payroll: $26,772

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Date of last update: 01 Aug 2025

Sources: Florida Department of State